German Society of Oto-Rhino-Laryngology, Head and Neck Surgery.
81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery.
Wiesbaden,
12.-16.05.2010.
DÃ¼sseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno075

Outline

Introduction: Cytomegalovirus (CMV) infection is the most common intrauterine viral infection. Approximately 0.1% of all newborns have visceral or cerebral symptoms due to CMV infection. Late complications such as hearing loss and delay in psychomotor and mental development are often found. Aim of the study was to investigate the development of children with symptomatic CMV infection after cochlear implantation.

Material and methods: Between 1996 and 2/2009 five children with symptomatic congenital CMV infection received a cochlear implant at our clinic. 4 children showed neuroradiologic abnormalities. Speech and language skills were assessed by standard speech perception, receptive and expressive language measures (Mainzer children speech understanding test, GÃ¶ttinger children mono-syllabic speech understanding test, Schmid-Giovannini and Pollack score). 19 children with connexin-26-mutation served as a reference group.

Results: : The mean age at the time of implantation was 29 months (range, 1–3 years) for children with CMV infection, 33 months (range, 1–5 years) for the group of connexin-26-mutation. The follow-up period in the CMV-group ranged from 1 to 5 years (mean, 2.9 years). In the MRI/CT- scan 4 children showed white matter lesions and 2 children had intracranial calcifications. The children widely varied in their development process during rehabilitation. Children with microcephaly (n=2) performed obviously poorer in tests which evaluated the expressive speech development.

Conclusion: Children with symptomatic congenital CMV infection benefit from a cochlear implantation. Parents should be informed preoperatively about the wide range of results regarding the language development and speech perception. Furthermore an intensive rehabilitation program following implantation in these patients is needed. As previously reported by Noyola et al. the most specific predictor of poor cognitive outcome and subsequently also of poor speech development was microcephaly.